5 things parents should know – and do – to keep kids' hearts healthy

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Keeping kids healthy can be a big job. From the day their children are born, parents ferry them to and from medical offices, getting their immune systems boosted, teeth cleaned, eyes checked and stuffy noses decongested.

But experts say there's one body part parents and health care professionals may be overlooking: the heart.

"As a pediatrician, I am very concerned there is not enough attention to the growing problem of cardiovascular disease risks in children and youth," said Dr. Mona Sharifi, chief of general pediatrics at the Yale School of Medicine in New Haven, Connecticut. "We need to think about keeping their hearts healthy."

Heart disease and stroke are typically considered adult problems. But a growing body of research links cardiovascular events that occur in midlife to risk factors – such as obesity, high blood pressure, high cholesterol and smoking – that begin developing decades earlier, in childhood.

Some conditions, such as high blood pressure, are even showing up in childhood and adolescence. As a result, health experts recommend greater monitoring of children's cardiovascular risks and earlier interventions to control them as they emerge.

"Ideally, parents should think about their child's heart health even before their child is born," said Dr. Amy Peterson, a professor of pediatrics in the department of pediatric cardiology at the University of Wisconsin in Madison.

Studies show mom's health during pregnancy can affect her child's cardiovascular health as early as adolescence and well into adulthood. Maternal obesity, for example, can increase the offspring's risk for heart disease, stroke and diabetes in adulthood, as do maternal high blood pressure and diabetes.

"The start of what we think of as adult heart disease takes root in childhood or even before, even in the womb," Peterson said. "It's never too early to start thinking about that."

To prevent future heart conditions in their children, pregnant women should "make sure to eat healthy foods and stay physically active, as long as the doctor has said it's safe to do so," Peterson said.

Eating a healthy diet and staying active are two of eight metrics for good cardiovascular health outlined in the American Heart Association's Life's Essential 8. Others include getting enough sleep, not smoking, maintaining a healthy weight and keeping cholesterol, blood glucose and blood pressure levels within a healthy range. Adhering to all of these helps both mother and child, Peterson said.

"Anything that makes the mom healthier generally makes the baby healthier," she said.

Once children are born, experts say following those metrics can help them maintain good cardiovascular health that could last well into adulthood. Here are some steps they suggest parents take.

1. Model healthy eating

Introducing children to good eating habits and a wide range of healthy foods can go a long way toward helping them maintain a healthy weight and good cardiovascular health, Peterson said. Research shows dietary patterns established during childhood often continue into adulthood.

As they do for adults, federal dietary guidelines for children and adolescents encourage a diet rich in fruits and green, leafy vegetables, beans, peas, lentils, whole grains, lean meats and seafood. However, according to federal data, children in the U.S. have poor dietary quality, which deteriorates as they grow into their teens.

By late adolescence, kids are only getting half the fruits and vegetables they need and are overconsuming starchy choices such as corn and potatoes. Children of all ages consume excessive amounts of sugar, saturated fats and sodium. And they are putting on too much weight.

About 1 in 5 children and adolescents are dealing with obesity, according to the Centers for Disease Control and Prevention. Childhood obesity has been linked to health issues such as high blood pressure and cholesterol, diabetes, liver disease and mood disorders, Sharifi said. "All of these things go together and are frankly stealing life years."

Eating healthier, staying active and maintaining a healthy weight can boost cardiovascular health and help prevent other risk factors. But not doing so has the opposite effect, Sharifi said. "Unfortunately, we're seeing higher rates of childhood obesity and all of the associated conditions that go along with it. When you are young, small changes like replacing sugary sports drinks and juice with water can have a big impact on health."

Peterson said it's not enough to offer children healthy food choices. Parents need to model good eating patterns.

"Parents ask me how to get their kids to eat vegetables," she said. "I ask them what they're eating, and they tell me they don't like vegetables. Our children are watching what we're doing. If they watch us eat healthy foods and get regular physical activity, it's easier for them to build the same habits."

2. Stay physically active

Physical activity is key to good cardiovascular health, but kids aren't getting enough. According to the Office of Disease Prevention and Health Promotion, only 1 in 5 adolescents in the U.S. meets physical activity guidelines for aerobic and muscle-strengthening activities.

Federal guidelines recommend kids ages 6 to 17 engage in moderate to vigorously intense physical activity for roughly an hour each day. This should include mostly aerobic activities as well as some age-appropriate bone and muscle-strengthening activities, such as playground games, lifting weights, using resistance bands, running or jumping rope.

"Give kids opportunities to get their hearts beating faster for at least an hour a day, every day," Sharifi said.

Moving more can help kids maintain a healthy weight. But even if it doesn't keep the pounds off, research shows there are cardiovascular benefits to physical activity independent of weight loss. It increases cardiorespiratory fitness and decreases the risk for cardiovascular disease.

3. Check blood pressure and cholesterol

High cholesterol and high blood pressure are two major risk factors for cardiovascular disease, and both can begin to develop early in life. What's more, the longer these measures remain high, the more damage they can do to the body.

Because blood pressure and cholesterol can rise with no noticeable symptoms, parents and health care professionals may miss these conditions in children and adolescents, Peterson said. They need to be monitored during routine health exams.

"You may think that because a child eats a lot of fruits and vegetables and exercises regularly that they won't have these problems," she said. "But it's still important to check because there's no other way to know."

Children should have their cholesterol tested at least once between the ages of 9 and 11 and again between the ages of 17 and 21, according to guidelines published by the American Heart Association and American College of Cardiology. The American Academy of Pediatrics recommends children have their blood pressure screened annually beginning at age 3.

Eating a healthy diet and getting enough physical activity and sleep are usually sufficient to keep both blood pressure and cholesterol within range, Peterson said. But testing can help identify problems unrelated to diet, exercise and weight.

If children are genetically predisposed to high cholesterol, medication may be prescribed, she said. Children with high blood pressure may need to undergo additional testing to look for causes such as kidney problems or congenital heart defects. In some cases, medication may be appropriate.

Regardless of what's causing the problem, it's important to catch these conditions so they can be treated, Peterson said.

"If we ignore it, and a child has high cholesterol or high blood pressure for many years, it damages their arteries more quickly and they can be prone to heart disease," she said.

4. Recognize social drivers of health

In some families, the problem is far more complicated than making good choices about what to eat and how much to move each day, Sharifi said.

"It's not all about lifestyle choices," she said. Genetics and social drivers of health also play a role.

For example, Sharifi said, some schools don't provide enough opportunities for kids to move during the day. Families may live in neighborhoods that lack safe places to play after school and on weekends. Neighborhoods may lack access to quality health care or to stores that sell affordable, healthy foods.

And, families might not have enough money to make sure children are fed properly, relying on ultra-processed foods that are less expensive and have a longer shelf life. "This affects the way you eat and the way your body holds on to nutrition and calories for years to come," Sharifi said.

Not having enough to eat adds to stress and makes it harder for children to sleep, she said. Good sleep – an important component of good heart health – also may be more difficult for children if they live in noisy, urban environments. The recommended amount of sleep varies by age, with kids ages 6 to 12 needing nine to 12 hours and teens ages 13 to 18 needing eight to 10 hours, according to the AHA.

"Right now, it is hard to keep our children healthy," Sharifi said. "The odds are unfortunately stacked against you as a parent. We need to promote healthy lifestyles without denying the challenges families face today."

Sharifi said medical professionals should screen children for challenges that may interfere with healthy behaviors so they can help parents find ways to address them.

5. Have a heart-to-heart talk about CPR

Teaching children about good heart health also means teaching them what to do if they come across someone having a heart emergency, Peterson said. Some schools – even at the elementary school level – offer classes in hands-only CPR, which teaches children to call 911 and give chest compressions while they wait for help to arrive. Most states require learning the skill before students can graduate high school.

Sharifi, who recently took a CPR class with her 9-year-old daughter, said "kids are much more competent at a younger age than we give them credit for. We recognize that they might not be able to do chest compressions on adults as effectively when they are young, but they can begin to have the knowledge."

Each year in the U.S., about 350,0000 people go into cardiac arrest outside of a hospital, including 23,000 children, according to the AHA. So parents should learn the skill, too, experts say.

"The more we educate the community," Sharifi said, "the better."